Recently, a colleague of Ewan King, Director of Business Development and Delivery, at the Social Care Institute for Excellence (SCIE), received a call from a carer. They wanted to know how to access social care services. Ewan says this happens quite a lot…
As usual, my diligent colleague working on reception directed the caller to the appropriate local authority, so initially I thought little more about it. But then I read a report that suggested local authorities see improving information and advice as one of the major challenges they face in implementing the Care Act, and it made me think: Just how many people can’t find the information they need?
This is not to blame local authorities for this situation – providing up-to-date, relevant information and advice has been a challenge for years, not just for local authorities, but for all public services. It’s an issue that needs urgent attention. That’s because good information and advice is one of the critical building blocks of the Care Act. Good advice cannot only help people make good decisions when they really need help – for example, when they need a care home or homecare support – but it can also help prevent people needing more intensive support in the first place. For instance, it can introduce people to self-care or local support networks.
We train care staff on information and advice as part of our Care Act support offer, and we constantly hear staff concerns about information and advice. Questions such as: how will we find the time to update the information? How do we find out what support is available locally? And how can we make our website more accessible?
The first thing we tell them is that this isn’t solely their problem – it’s a whole system issue. The local authority can facilitate the development of better information, but it needs to do this in concert with the clinical commission group, GPs, the voluntary sector and people who use services and carers.
So one of the first things that needs to happen is the development of a clear vision for information and advice, perhaps avoiding the quick fixes of the past. This means connecting up a vision for information and advice to support the Care Act, with the local plans for the Better Care Fund, plus corporate information on benefits and advice, and other local initiatives, for instance around social prescriptions in health. The London Borough of Hackney points the way here, as it has developed a high-level corporate strategy for information and advice.
The second area of focus is over cultures and behaviours. We know at SCIE that if we are to get beyond mere compliance on the Care Act, then cultures, behaviours and values need to change. And the same is true for those providing information and advice. Those pulling together information and advice need to become adept at working with community groups, in collaboration, and in seeing information in the broadest sense. Look no further than Think Local Act Personal’s strategy guide on information and advice, for how to work on the right cultures to make this happen.
And the third area is ensuring information and advice is linked to wider service redesign. Information and advice provision is not just about producing better websites – although this is important – but it’s also about remodelling services around the people who use them. In Shropshire, for instance, as part of a redesign of social care services that seeks to promote preventative services and community resilience, they have established the Let’s Talk Local initiative. This seeks to signpost people - who would be better supported through non-social care services - to other community assets and services. The new model has involved setting up an initial point of contact who provides basic screening and signposting and, if further support is required, the person is passed to a team of social work assistants. They then engage in a solution-based conversation to explore the person’s personal assets and other community-based support and resources.
And finally there is much that can be done about directories and websites. In the best cases, what we are increasingly seeing is examples of co-design and co-production of websites, involving local people, in identifying what information they need; and in sharing their knowledge about local assets and resources. Stockport’s My Care, My Choice site has been co-produced with people who use services, and local charities provide a user-friendly window into a broad range of support services, community assets and advice.
We’re proud of our Care Act resources at SCIE because they can help users, carers, staff and others, who can sometimes struggle to navigate the social care world; but it’s vital that what they need is also available at just a call or a click away, at the local level. The future of the Care Act relies on it.
10 comments
Comment by Gillian Dalley posted on
I, along with two colleagues, (Bright, L, Clarke, A and Dalley, G) wrote a paper 'Finding out about social care: what information seekers want' published in 2013, in Working with Older People, vol 17, issue 2, pp 85-94 based on research into information seekers' experiences of looking for care services. It says it all!
Comment by Peter Palmer posted on
Rule of thumb for all communications: Keep It Simple.
By definition, the people needing the advice are looking for help. They want to know what is available and how to access it.
Not everybody has access to or uses computers. Bear that in mind.
Consider who any particular help is aimed at.....and their particular ability to find the information.
One size doesn't fit all needs. Put yourself in the position of the person needing help.
Make life easier for them. Keep it simple.
Oh, and for heaven's sake talk to each other.
Comment by Trevor Fossey posted on
The lack of information available from Social Care is evidenced by the systemic 'secrecy' that persists as part of the Social Service training.
As a specific example, I have been deliberately obstructed by Sandwell Social Services in the care and rehabilitation programme that I have put in place for a person with profound dementia, who Social Services wanted to commit to a nursing home 12 years ago, but whose wellbeing has benefited from my input. Sharing information would undoubtedly benefit the individual, But Sandwell Social Services don't want to share information and are deliberately obstructing improved wellbeing. @TrevorFossey
The culture of systemic 'secrecy' needs to be changed?
Comment by Trevor Fossey posted on
The Power of Information, which was published in May 2012, has promised that all service users of Social Care would be empowered by having online access to their social care records (which they could choose to share). The fact that no Local Authority has yet progressed this promise, and that many are resisting the culture of engaging service users in this manner, is evidence that Social Services will continue to resist sharing information - and that information will remain a hurdle that will prevent the Care Act being effective.
Comment by Paul Twyman posted on
"This is not to blame the local authorities"- indeed not! The finger of blame should be pointed at central government who put together poorly drafted, complicated legislation and then expect citizens and the professionals to grasp it without much guidance. There is some guidance, to be sure, but not customer-oriented. Ask anyone working in an MP's office and they can tell you what problems legislation causes, just getting to the bottom of what it all means for constituents. It does not help that the GOV.UK web site is led by "techies" and not by staff with an understanding of the needs of customers/clients. The old Central Office of Information had considerable expertise (built up over decades) but that central asset was killed off by government. Individual departments have built up some capability but too often these folk are more interested in showing off their clever technological gimmicks than doing the boring old stuff of writing comprehensible guidance.
Comment by Carole Cliffe posted on
As the parent of a young man with severe and complex needs I speak from an informed position when I say experience has taught me that local authorities do not give a fig, that the sole aim of the process is to ensure people are not enabled to access services and are not supported in making choices rather the decisions are disproportionately in favour of the council. I live in an area with a poor performing services and the services on offer are substandard and fail to meet the service users requirements/needs. Social services restrict not enable clients and believe me I have had to dig and find an unprecedented strength to take on the culture within the self proclaimed service. The assessments are generic and fail miserably to appropriately assess needs and all I experienced was a bullying and intimidating service that consistently changed goal posts to ensure outcomes were never achieved any complaints never resulted in outcomes merely parents experiencing being labelled as persistant complainers by indiviuals who work consistently outside the framework of law in place!! you could not make it up.
Comment by Pearl Baker posted on
Some Social Services are not only ignoring the rights of carers, but individuals they are supposed to support in the name of money.
I would suggest that there is a feedback 'mechanism' to this department, and then you will understand the extent of the problem. In my area 77% of Senior Social Workers, and 24% Social Workers are Agency staff. This particular LA have received a very 'bad' Ofsted report for children, and is to invest £100.000 in training? Agency staff? I understand they are offering an additional £15000 to each Social Worker if they stay for three years.
It is important to understand you may request a Carer Assessment, and in fact have a Carers Assessment, concluding that you are not recognised as a Carer, despite, the fact that you speak every day on the telephone, visit each week, to clean, launder their cloths,take food, organise their medication with the Pharmacist, and manage a Garden Project for them, all at your own expense.
Many of us know our rights, but it makes know difference.
Comment by Kate Baxter posted on
Thanks Ewan for raising this important issue. Our review of research evidence about self-funders for the NIHR School for Social Care Research confirmed that self-funders find it particularly difficult to find information about social care (see http://php.york.ac.uk/inst/spru/pubs/2871/). We have just started another SSCR-funded study aiming to explore and provide for the information needs of self-funders. For more details see http://php.york.ac.uk/inst/spru/research/summs/sign.php.
Comment by John Galvin, EAC posted on
Ewan succinctly makes a number of key points about what’s needed to knock information and advice (I&A) services into shape to meet the needs of current and potential social care clients. He rightly acknowledges that we’ve had a problem for years, and that a new vision is urgently needed, plus the will to involve users and think outside the box to find sustainable solutions relevant to today’s circumstances.
His analysis has much in common with the one that brought a handful of national I&A providers together in 2008 to pilot a joint service which evolved into FirstStop Advice for older people. FirstStop is now delivered through a partnership between national charities Elderly Accommodation Counsel (EAC), Care & Repair England and Independent Age, plus 27 local Age UKs, home improvement agencies and local authorities. Supported financially by DCLG, Comic Relief, the Big Lottery, Nationwide and Legal & General, as well as partners’ own resources, it provides a comprehensive I&A service spanning care, housing and related finance, delivered though a website and web apps, linked telephone Advice Lines, face-to-face casework and peer mentoring. In 2014-15 the service reached 4 million people of whom 22,000 received personal advice and guidance, 2,000 intensive casework and a smaller, but fast growing number, peer support.
Equally importantly, FirstStop is a learning network in which innovative approaches are pioneered and shared amongst its partners.
FirstStop is now well developed, independently evaluated and proven. Its challenge is to scale up dramatically and to ensure that it does so in a way that continues to successfully address the challenges Ewan cites – from updating information resources to making websites accessible; from addressing prevention to responding to immediate needs; from embracing co-production and co-design to achieving maximum efficiencies and value for money throughout the system. We would add one other imperative – to replace signposting with referrals wherever possible for vulnerable clients and those at most risk, ensuring that they don’t fall through gaps between agencies and making it far more possible to track and evidence outcomes and the savings to the public purse that such interventions can deliver.
Scaling up won’t be easy. Our successful websites already enable us to cite large customer volumes, but a litmus test of a good, rounded service must be that it can get personal and offer a 1:1 conversation when it’s needed. And there’s no certainty that EAC and its national partners will be able to maintain our contributions to FirstStop at current levels through into 2016-17, whilst our intelligence suggests a rapid reduction in local capacity as cuts bite.
However, back to Ewan’s final point. If the intentions of the Care Act are to be realised, we must put all the creativity we can muster into delivering ever more effectively, as so many FirstStop partners are already doing, and at the same time shout about our achievements over the last 7 years, persuade more agencies and authorities to join the FirstStop network, and make the case ever more persuasively – and widely – that that we have a service model that’s proved itself and is worth investing in.
John Galvin, CE, EAC
Making the Case – for integrated, impartial information and advice about housing and care for older people
(http://www.firststopcareadvice.org.uk/news/item-leading-ia-organisations-set-out-the-case-for-what-they-do--3fe89.aspx)
http://www.firststopadvice.org.uk
http://www.housingcare.org
Comment by Karl Jonathan Womack posted on
I am a resident in care and I feel mollycoddled by the Care Act as you don't seem to as the people in adult social care what they want.